Device for temporary dental splinting

ABSTRACT

For the temporary fixation of teeth, teeth rows or jaw parts, the device has a wire (9), on which annular composite carriers (7) are movably arranged. The composite carriers (7) can, for example, be flexible synthetic material rings of cross-section in the form of a truncated cone, through which the wire (9) is guided by means of two holes (8) arranged in the walls, which lie opposite one another, of the composite carriers (7). 
     The new splint makes possible the exact positioning of the composite carriers (7) which are arranged movably on the wire (9) and can be deformed at will by hand. After a caustic pretreatment of the tooth surface, the composite carriers (7), which are joined together by means of the wire (9), are placed on the teeth row to be connected and the cavities (A) of the composite carriers (7) are filled with composite (K) which surrounds on all sides the wire (9), which runs at a distance from the tooth surface, and connects both the wire (9) and the composite carriers (7) stably to the tooth surfaces. 
     Use for the temporary fixation of traumatically dislocated teeth after their repositioning or for post-operative immobilization of jaw parts. The decisive advantage of the device is that it can be used not only by dentists, but also in particular by non-dentally trained personnel, that is to say emergency doctors, surgeons and auxiliary medical personnel.

The present invention relates to a device for the temporary fixation ofteeth, teeth rows or jaw parts, especially in the case of toothdislocation and in the case of surgical interventions on jaws.

Wounds in the area of the teeth and jaw lead in many cases to theloosening of teeth which can usually still be saved, providing that thenecessary emergency treatment can take place quickly. Within the scopeof such emergency treatment, the traumatized teeth are repositioned andmust then subsequently be temporarily fixed to the undislocatedneighboring teeth as quickly as possible by means of splinting. Theimmediate repositioning and splinting is an absolutely urgentprerequisite for successful treatment because of the rapid degenerationof the remaining periodontal tissue as well as the formation of bloodclots in the alveolar area, which hinder the repositioning of thedislocated tooth. There is also the risk that after a certain period oftime an initially partially disllocated tooth detaches itself and entersthe windpipe.

Splints in the area of the teeth can also be necessary in order to bringabout temporary, and more specifically intramandibular, intramaxillaryor intermaxillary, fixations in jaw surgery.

According to a known currently used technique, the dislocated andrepositioned tooth is connected to its neighboring teeth by means of ametal wire which, after an etching pretreatment, is fixed to the frontsurface of the teeth by means of composite material. The use of thisknown method requires special mastery of material and technique and canthus only be carried out by a dentist but not by the emergency doctor orthe family doctor who in such cases is usually initially called in oravailable.

For the long-term after-treatment of gnathoorthopedic cases, it is knownto stick rigid, metal holding elements, so-called brackets, onto thetooth surface. All these holding elements are connected to one anotherby means of a metal wire which is loosely guided through them. By meansof tensioning and, if necessary, periodically retensioning of the wire,adjustive tensioning forces are transmitted via the holding elements,which in this case have the function of transmitting forces, to theteeth to be treated. This method also can only be applied by the dentistwho is familiar with it; moreover, the rigidity of the holding elementsrenders their exact positioning more difficult.

It has also already been attempted to produce a dental splint withsynthetic material only, that is to say without a wire-shaped connectinglink. This method could not be implemented, however, at it is difficultto shape the synthetic material exactly and, on the other hand, it oftendoes not withstand the forces which arise in the area of the teeth, theremoval of the synthetic material has also proved difficult.

As the composite material must be removed again after a certain time, itis important that from the outset an amount which is as small aspossible if this material is applied, in other words that the adhesionsurface is delimited as exactly as possible, whereas on the other hand,however, the wire-shaped connecting link is nevertheless to be securelysurrounded by composite at the respective fastening point and theformation of hollow points, in particular between wire and teethsurface, must be avoided.

It is the object of the present invention to propose a device for thetemporary passive splinting of teeth, which can be applied without risknot only by dentists but also in particular by a family doctor, anemergency doctor, a jaw surgeon and if necessary by auxiliary medicalpersonnel also.

The new device is on the one hand to limit the application of thecomposite, which secures the wire-shaped connecting link on the toothsurface, to the amount of composite actually necessary and on the otherhand to make it possible exactly to select the position of the fasteningpoint on the tooth surface.

The invention is directed to a wire-shaped connecting link and aplurality of composite carriers mounted thereon for receiving acomposite material and limiting the area of each tooth surface to whichthe composite material is applied.

A number of exemplary embodiments of the device according to theinvention are described below with reference to the attached drawing.

FIG. 1 illustrates the use of the device according to the invention onthe external surfaces of the teeth on the maxillary and mandibular side,

FIG. 2 shows a first embodiment of the device according to theinvention,

FIG. 3 shows the application of the device on the external surface of ateeth row on the maxillary side,

FIG. 4 is a front view of an area of teeth, which has been splinted onthe external surfaces of the teeth on both the maxillary and mandibularside, both jaw parts being connected in an intermaxillary manner,

FIG. 5 shows a use on the internal surfaces of the teeth, lingually andpalatally,

FIGS. 6a-6e show a number of possible cross-sectional designs of annularcomposite carriers and

FIGS. 7 to 11 illustrate examples of use on the oral and/or facialsurfaces of the tooth parts on the maxillary and/or mandibular side.

FIG. 1 shows the teeth rows of upper jaw, maxilla, (1) and lower,mandibula, (2), on which an embodiment of the device according to theinvention is shown by way of illustration. On the external surfaces ofthe teeth indicated by (3) and (4) respectively, splints (5) and (6)respectively are arranged, as they may be necessary, for example, inorder temporarily to fix a traumatized tooth to its neighboring teeth ortemporarily to immobilize an entire jaw part (in the case of a brokenjaw, for example).

For the exact definition of the present invention, it is first of all tobe pointed out that the same is intended neither for active splintingnor for the long-term orthopedic treatment of tooth misalignment or jawanomalies. The field of use of the device according to the inventionlies exclusively in the temporary passive fixation of teeth, teeth rowsor jaw parts, such temporary passive fixation measures to be takenimmediately after accidents or surgical interventions, which until nowcould not be carried out without calling an expert dentist or jawsurgeon. By virtue of the instruction according to the invention suchtemporary measures can now also be carried out easily by care personnel(family doctor, emergency doctor, surgeon, nursing personnel) presentafter an accident or an operation, by virtue of the simple applicationof the invention.

Accordingly, for the purposes of use of the device according to theinvention, it is a prerequisite that any traumatically dislocated teethhave first been repositioned and according only a temporary fixation isstill necessary.

To this end, a prefabricated splinting device is used as is illustratedin FIG. 2, for example. The device has a row of annular compositecarriers (7), the wall parts of which lie opposite one another, in eachcase have a through hole (8), through which a wire (metal or syntheticmaterial) (9) is drawn in such a manner that the composite carriers (7)can be moved along the wire.

The composite carriers (7) consist of a flexible synthetic material andare, for example, sections of an extruded synthetic material tube, sothat they can be plastically deformed by means of finger pressure.Polymethylmethacrylate, for example, can be considered as the basicmaterial for the composite carriers (7). The wire (9) can consist ofeither stainless steel (metal) or a suitable synthetic material.

This splinting device, which is illustrated schematically in FIG. 2, isthen applied to the tooth part to be connected, after the intendedfastening point has been pretreated with a caustic agent, in general 40%phosphoric acid. To this end, the splinting material, which can, forexample, be kept in stock as goods sold by the meter, is cut to therequired length and adapted approximately to the curvature of therelevant teeth row. After the composite carriers (7) have been placed onthe intended fastening points, they can be optimally positioned byvirtue of their movability on the wire (9) and of their elasticdeformability. In this treatment stage, all the composite carriers (7)are consequently situated on the fastening points, while the wire (9)penetrates all the composite carriers (7) but does not touch thesurfaces of the teeth, being guided rather at a distance in front of thesame. The recesses (A), which are bounded by the composite carriers (7),are then filled with composite materials (K) and excess compositematerial is scraped off. In this manner, a fixation is simply achieved,which is agreeable to wear and which--provided the necessary accessoriesare available--can also be applied by the non-dentists in the shortesttime.

In FIG. 3, the splint is shown again in detail and on a slightly largerscale using the example of a tooth fixation on the maxillary side. Inthis case, the left half of the splint has already been fastened withthe three composite carriers (7) situated there to the adjoining toothsurfaces by means of composite material (K), whereas the recesses (A) ofthe remaining three composite carriers (7) are still to be provided withcomposite material.

In the event that the fixation method should prove to be inadequate inindividual cases, it can of course be combined with known fixationmeans, for example an additional wire ligature which surrounds anindividual tooth.

FIG. 4 shows a further use. Here, for example, the requirement may existto fix maxilla and mandibula to one another temporary with regard to thehealing of a jaw fracture, in order by these means to immobilize thepoint of fracture during the first period of the healing time. In thiscase, both the external surfaces of the upper (maxillary) and those ofthe lower (mandibular) teeth are provided with a splint. For the mutual,intermaxillary connection of the two jaws, the two wires (9) are coupledto one another by means of connection members (10). These connectionmembers (10) can be, for example, metal, C-shaped, plasticallydeformable clips, self-fixing plastic loops or also simple wireligatures.

A preferential design of composite carriers (7) is illustrated inconnecting elements (10) characterized by direct attachment of thecomposite carriers. The preferential composite carriers (7) possess ahook-like appendage mechanism which relays a rounding off of the formthus providing the ergonomic design.

Practical use has demonstrated that this improved design of thecomposite carrier provides a very high level of wearing comfort for thepatient.

One of the most important advantages of this particular design is theavoidance of accompanying tension producing untoward effects on andthrough the splint due to the direct attachment of connecting elements(10) to the composite carriers (7). Another important point to add isthat connecting elements (10) produce undesirable torsion and shearingforce when attached to wire component (9), which, even when performed byversed, proficient practitioners, are nevertheless very difficult tocorrect and supervise. The attachment of connective elements (10 and 14)directly to composite carriers (7) thereby enables utilization of splintalso by less qualified personnel while still attaining good and stableresults.

FIG. 5 shows schematically the application of the splint described tothe internal tooth surfaces (lingual and palatal). This type ofsplinting has inter alia the advantage that it is obscured from viewfrom the outside. In association with splints on the external toothsurface, an increase in the intramaxillary, intramandibular and alsointermaxillary splinting stability can be achieved.

Within the scope of the present inventive idea, the decisive element isthe composite carrier (7) which makes it possible to combine simple useof the device with good wearer-comfort and excellent stability. Thethree possible cross-sectional shapes of composite carriers (7), that isto say an annular ring (a) of circular cross-section, a cylindricalsection (b), a truncated cone (c) and a dome-shaped alternative (d, e)are illustrated in FIG. 6, the adjoining tooth (Z) only being indicatedin the case of the alternative in the form of a truncated cone (c). Itcan be seen here how the composite material (11) fills the cavitybounded by the composite carrier (7), in this connection surrounds onall sides the wire (9) situated at a distance from the tooth surface andsecurely connects both the composite carrier (7) and the wire (9) to thetooth surface. The composite carriers (7) can be round, oval or alsopolygonal according to requirements. The two through holes (8) (FIG. 2)for the wire (9) do not necessarily have to lie diametrically oppositeone another, but can in special cases also be mutually offset.

The main uses of the splint described are again schematicallyrepresented in FIGS. 7 to 11, in which

FIG. 7 shows an intramandibular buccal splint with a wire ligature (13)applied to two teeth,

FIG. 8 shows an intramaxillary buccal splint, likewise with additional,twofold securing by means of wire ligature (13),

FIG. 9 shows a splint on both sides, that is to say buccal/lingual, inwhich the wires of the two splints are connected by means of wireligatures (12),

FIG. 10 shows an intramaxillary and intramandibular fixation which issecured by means of local wire ligatures (13) and

FIG. 11 shows an intermaxillary fixation, in which the splint wires ofthe two jaws are secured to one another by means of plasticallydeformable metal clips, self-fixing synthetic material loops or wireligatures (14).

The ergonomically designed composite carriers illustrated in FIGS. 6dand 6e are especially practical for use in antagonistic tooth fixationin both jaws. In the simplest case, the composite carriers (7) areannular with adaptation (15) in which the connective elements (10 and14) allow hooking up. The preferred design of composite carrier (7) isillustrated in FIG. 6e.

The composite carrier (7) is characterized by enhancement throughergonomic principles as seen in the construction, a skull-capped mannerwith openings, (16 and 17) allowing a hooking up mechanism forconnecting elements (10 and 14), as well as the possibility for completefilling with composite material. The openings possess dimensionalcharacteristics specially designed to allow better application ofworking material, light/energy source for curing the composite.

It is important to realize that further development of composite carrierlies in the hands of the specialist depending upon his or her knowledgeand technical capability. Of utmost importance is that design of thecomposite carrier may also include multiple connecting elements (9),e.g. a convenient way for fixation between anterior and posteriorsplints. It must also be understood that the convenient use, based uponthis innovative splinting device and the fricarive contact of thecomposite carriers with connector (9), whereby connector (9) requiresuse of a square wire, contributes to a reliable result.

We claim:
 1. A device for the temporary fixation of teeth, teeth rows orjaw parts, as for example in the case of tooth dislocation or in thecase of surgical interventions on jaws, comprising:a wire-shapedconnecting link, said link adapted to be anchored on at least one ofexternal and internal tooth surfaces of each of a number of neighboringteeth, and a row of annular composite carriers arranged movably on saidconnecting link, said composite carriers made from a flexible syntheticmaterial, each said composite carrier bounding a recess which is adaptedto receive and limit spreading of a composite material to be applied toeach tooth surface, each said composite carrier having walls which lieopposite one another and adapted for said connecting link to passtherethrough, wherein said device is affixed to said teeth byapplication of a composite material to each tooth surface and whereinfurther, after application of said composite material, said connectinglink lies at a distance from said tooth surfaces and is surrounded onall sides by said composite material.
 2. The device as in claim 1,wherein the annular composite carriers have, on each of two sides whichlie substantially opposite one another, a through hole, through whichthe wire-shaped connecting link is guided.
 3. The device as in claims 1or 2, wherein the composite carriers have an ergonomic design.
 4. Thedevice as in claim 3, wherein each composite carrier is a mechanismhaving an appendage in the form of a hook.
 5. The device as in claim 3,further comprising openings in the composite carriers which areconsipated for ease in filling and curing of composite material.
 6. Thedevice as in claim 3 wherein the wire-shaped connecting link is made ofa material selected from the group consisting of stainless steel and anelastically deformable biocompatible material and the composite carriersare made of plastically deformable synthetic material.
 7. The device asin claim 2 wherein the wire-shaped connecting link is made of a materialselected from the group consisting of stainless steel and an elasticallydeformable biocompatible material and the composite carriers are made ofa plastically deformable synthetic material.
 8. The device as in claim1, wherein the wire-shaped connecting link is made of a materialselected from the group consisting of stainless steel and an elasticallydeformable biocompatible material and the composite carriers are made ofa plastically deformable synthetic material.
 9. A method for thetemporary fixation of teeth, teeth rows or jaw parts, as for instance inthe case of tooth dislocation or in the case of surgical interventionson jaws, comprising the steps of:providing a connecting device having awire-shaped connecting link and a row of annular composite carriersarranged movably thereon, each said composite carrier bounding a recesswhich is adapted to receive and limit spreading of a composite materialplaced therein, positioning said connecting device over at least one ofan external and an internal tooth surface at each of a number ofneighboring teeth, affixing said connecting device by applying acomposite material to each tooth surface in an area corresponding toeach said composite carrier, such that said connecting link issurrounded by said composite material and lies at a distance from saidtooth surfaces.
 10. A method as in claim 9 for the mutual,intermaxillary fixation of maxilla and mandible, further comprising thesteps of anchoring said wire-shaped connecting link on the maxillaryside of a patient and coupling the mandibular side of a patient byproviding connecting members.
 11. A method as in claim 9 forantagonistic intermaxillary fixation of maxilla and mandible, furthercomprising connection of maxilla and mandible by tooth-based anchoringof said device, maxillary and mandibular.